NPI | 1154464154 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 18186) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 18186) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2009-12-14 |